7714 SW REDHAWK COURT ADDRESS:
i:\records\microfim\targets\buiiding.doc
DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
COUNTY,
155 NORTH FIRST,HILLSBORO,OR 9'124
COUNTY, INSPECTION REQUESTS: 503/1340-3561/693-4415
OREGON
Date : Oh/1b/`jb
I';R'a . 13, _39
t✓lract.rr_a1 Permit Permit # Uhtt6'I'I7ti
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Pt-r'',Lt. StatLl3 At'PRUVELI Applie d 0'7/1b/9�j
,.,itus At..:tdre:_;.:, // 1,4 :-W kEL?HAWK C '1'1 issupo 01- /16/4�1
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Pe mit Pesci 1, , V, !•'t>11 CABLIE AND PHONt:: ONLY Expire .11/12/91.1
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I ['1\LA'1-'l.N , uR 1'Ji:bk'. VcIli(3jited by KY:l+
f1j:,I,i1.iC'tiflr LtL(.�_ e : f,9Z7381c,1 1_YLri(;'tor:ti)r Area
t•'Cu2 dC 0 L 1 j:,t:..t ,. l'1 1Inl7, L'cue/Uri i t h'X t I oF.. Data
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Total ' i e C t L1.Cal. r'Cra,, . 1 ,11
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MI,+:!'7Cx_i Ch. k 14 R,2,_eipt Nr' , L'at' i)rlyllion
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'1 H 1,, L)A': 194 . 2'
A,tju::trnerL+:s : ;., , 1,.,tE(1. ;_ t (_,I11- tI
'1't:tai r'e?es : 194 . 2 !'c,taI Payment 2 94 .
NOTICE: This permit becomes null and void If the work or construction for which It In Issued Is not commenced within 180 days. Once construction has started,
the permit becomes nulf and void It construction Is interrupted fer a ported of 180 days. I certify that the Information presented by the applicant and
his agent or agents in support of this permit is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false Arid misleading Information may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building or structure will he compiled with whether or not speclf4d on the pians or noted on the pians correction sheets I acknowledge that
the granting of a w3rmlt does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspect+ons at various times during the process of construction end the building
Inspection staff vs.ifying compliance with the various codes. Liao or occupancy of the building or structum permitted prior to approval by the
Sulidlog Department Is solely at the risk of the appllcsnt and such use or occupancy i'u revocable until all Inspection requirements are satisfied and
ap,Tnval Is given by the Building Official. I further acknowledge that a Ilea may be placed on the title of the property upon which the permit Is Issued
spa,Ifying that the use or occupancy of the building or structure Is provisional ans4 revocable until the satisfaction of all Inspection requirements
APPLICANT'S SIGNATURE
DEPARTMENT OF LAND USE & TRANRPORTA7 ION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION#350-12
155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE: 503,1640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
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RE,' FILE('
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Descript. i,:,n I, .V FOR CADi-E ANI) PRONE oNLY”
Job, Aldxr aZ 7'114 I�EDJJA.WK t."T TT
Owi,.er Name INSPECTI(!N TT;;ARD t,
Applicant Name H(. LLMAN C"s'411,14..NY
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r WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Ilse & Transportation
1i Electrical Inspection Section APPLICATION
155 North First Avenue, x350-12
Hillsboro, Oregon 97124
Information: (503) 640-3470 Fax: (503) 693-4412
Permit
Number (. �,)�G' , l�} / Date' PLEASE PRINT
Please 4. Complete Fee Schedule below
1. Location of instal atin Number of inspections per permit allowed
Address_. 4±J (_ (I!.CetJk �`+ Service included: Items Cost(ea.) Sum
\ Bui,din A. Residential-per unit
City `J'�,� t SlJlte O. 1000 sq.ft.c,less �, $110.00 11 4
Tenant Name Each additional 500 sq.ft -7 '
(if commercial) or portion thereof _c�kk $25.00
-`r C 1 Limited Frergy $25.00 �� ___ 1
Map No. T ax Lot L1 Each Manuf d Home or Modular
Thomas M Book:
Dwellirg Service.or Feeder $68.00 2
P ge: Secrio
Di,r ctions_�_- �' t ���-- i,' B. Services or Feeders
L
�L �_yy` i� Instellati m,alterations or relocation
200 an ps or loss $60.00 2
Commercial ❑ Residential� 201 amps to 400 ar tps $130.00 2
401 amps to 600 amps $120.00 2
2a. Contractor installation only: 601 amps to 1000 amps -- $180.00 - --- 2
( Over 1000 arnps or volts $340.00 _ 2
Electrical Contractor_luck Z�i{t(' yt r^C(_-�'- Reconnect only _ $50.00 2
Address ErL? 1.4VC IF
City 1 Statte��-ZIP ^ C. Temporary Se,vices or Feeders
Date t5 Job Number � (-opt -- Installation,alteration or relocation
Property Owner-._ a_lne ll U1\�n u� l 1��_ 200 amps or less $50.00 2
Contractor's License No.
201 amps to 400 amps $75.00 2
3 1 Z�;2_. 401 amps to 600 amps $100.00 � 2
Contractor's Board Reg. No. 'kS'-,k�A Over 600 amps to 1000 volts see'B'above
Signature of Supr. Elec'n �+ -� `� _ D. Branch Circuits
License Nu._ PhoneNo. t 7_ New,alteration or extension per panel
a) The fee for branch circuits with
2b. For owner installations: purchase of service or feeder lee.
Each branch circuit -_ $5.00 2
Print wrier's e Phone o, _.-` h) The.cc for branch circuits without
purchase of service or feeder lee.
ress - e --- First branch circuit _._ $35.00 2
Each arid'ril branch circuit_-_ $5.00 _ 2
,tidy-- tole -`-Z p -- E. Miscellaneous (Service or Feeder not included)
Fach pump or irrigation circle $40.00 2
The ;r,stallation is bell) ade on property / own Each sign or ouuino lighting $40.00 2
wh ch is not intended for le, lease or rent. signal circuit(s)or a limited
energy panel alteration
Owner's Signature -_____ or extension $40.00 2
F. Each additional inspection over the allowable
in any of the above
3. Pian Review section (if required) Per inspection _ - $35.00 _Per hour $55.00
Plefaecheck Appropriate hem and enter fee In section 5B. In Plant _ _ $55.00
4 or more residential units in one structure
Service and feeder, 800 amps or more 5. Fees
System over 600 volts nominal A. Enter total of above fees $ ---l ��-
_Classified area or structure containing special 5% Surcharge (.05 X total fees) $
occupancy as inscribed in N.E.C. Chapter 5 Subtotal $
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $ -----
above apply. Not iequired for temporary construction .Subtotal $
services. ❑ Trust Account $
Balance Due $
For inspections call thisrmlt becomes null and void M the work authorized b
Pr' y the permit la not commenced
640-3561 or 693-4415 within 100 days from date of Issue nee of such permit or if the work wlhorl.[ed is
suspended or abandoned at any time after work is commenced for a peflool of ISO deVe.
24-hour recorder, one working day in advance of need electrical Permits are non-refundabie and non transferable.
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